Major shift in how to prescribe statins in US

Updated
November 13, 2013 15:33:00

There's been an overhaul of the guidelines used to prescribe cholestoral-lowering statin medication in the United States. The guidelines issued by two leading US medical organisations recommend stronger measures for patients at particularly high risk of heart attack or stroke. The move has been welcomed by Australian authorities, but Australia's Heart Foundation says the shift doesn't support recent controversial claims that too many people are taking statins.

ELEANOR HALL: The American Health Association, along with the American College of Cardiology, have released new guidelines for doctors to help assess who should be taking cholesterol-lowering statin medication in the United States.

But Australia's Heart Foundation says the shift does not support recent controversial claims that too many people are taking statins.

Stephanie Smail reports.

STEPHANIE SMAIL: The American Heart Association says cardiovascular disease is the number one cause of death in the United States and a huge burden on the health care system.

It's released new guidelines to help identify adults at high risk of developing cardiovascular disease and those who would benefit from lifestyle changes to help prevent it.

Doctor Robert Grenfell is from Australia's Heart Foundation.

ROBERT GRENFELL: This is a major leap forward for them with regards to improving the grading of risk and also the management of that risk. And also cementing the fact that all those who've had an event need to be on therapy.

In Australia alone we know that poor secondary prevention is leading to around about $8 billion of unnecessary health costs a year. That is people having secondary events who are not actually being treated with the appropriate agents.

STEPHANIE SMAIL: Until now a specific cholesterol-level target has been set for patients in the United States, with doctors prescribing extra drugs on top of statins to reach that goal.

The new system in the United States does away with those targets.

Dr Robert Grenfell says targets are still in place in Australia but local authorities are considering dropping them too.

ROBERT GRENFELL: The point of taking away the targets is respecting the fact that we need to be on the drugs, that it decreases your chance by as much as 30 per cent. And the marginal effect of actually getting to those lower levels of course is not necessarily worth the effort of in fact actually prescribing or adding extra drugs which can cause additional side effects.

STEPHANIE SMAIL: The US guidelines have been changed to include the risk of stroke as well as heart attack.

They also set down new formulas for predicting risk in African-American and white women and men.

Similar guidelines are already in place in Australia, New Zealand and the United Kingdom.

Dr Robert Grenfell says it's the right treatment approach.

He says all people at high risk of having a cardiovascular event - or have had one - should be on statins.

ROBERT GRENFELL: This certainly does not support the contention that too many people are on statins. What it is, is it's a shift towards making sure that the right people who will get benefit from those statins are actually on those, and those who have marginal benefits are able to consider whether or not they should be on the statin.

STEPHANIE SMAIL: Dr Robert Grenfell says in many ways this shift brings the United States into line with Australia, New Zealand and the United Kingdom.

But he says there's still a lot of work to do to get Australians on the right treatment.

ROBERT GRENFELL: Two million Australians over the age of 45 have unmanaged blood pressure. That's a problem. And in that group, one million of them also have unmanaged cholesterol. So that's one million Australians are out there at high risk of having a heart attack or stroke, who really need to be found and managed.